The influence of mode of anaesthesia for caesarean delivery on neonatal Apgar scores in the Czech Republic and Slovakia: secondary analysis of the results of an international survey in 2015

Abstract

OBAAMA-INT Study Group Aims. The purpose of this international survey was to describe the impact of current practices and techniques of caesarean section on the neonatal Apgar score in the Czech Republic (CZE) and Slovakia (SVK). Methods. All Czech and Slovak departments that provide obstetric anaesthesia were invited to participate in a onemonth (November 2015) prospective study that monitored in details all peripartum anaesthetic practices, delivered by anaesthesiologists. Participating centers recorded all data on-line in the CLADE-IS database (Masaryk University, CZE). Results and Discussions. We collected data of 10119 women who delivered 10226 newborns. A caesarean section was recorded in 25.1% of deliveries (CZE 23.2%; SVK 30%). General anaesthesia was used for caesarean section in 37.5% of the cases (CZE 40%, SVK 33%). There was no statistically significant difference in the Apgar score lower than 7 in the 1, 5 or 10 min in groups of general and regional anaesthesia for caesarean section, when only elective sections of in-term babies with birth weight over 2500 g were analyzed. We found no statistically significant differences in the Apgar score in newborns of women intubated for caesarean section in rocuronium (n=21; 2.2%) and suxamethonium (n=889; 93%). Conclusion. We found no difference in neonatal outcomes in groups of general and regional anaesthesia for caesarean section when only out-of-risk newborns were analyzed. The risk factors were identified as follows: an acute caesarean section, preterm babies, birth weight less than 2 500 g, born in perinatological center and multiple pregnancy-second baby. Trial Registration: ClinicalTrials.

Maternal Satisfaction and Its Associated Factors towards Spinal Anesthesia for Caesarean Section: A Cross-Sectional Study in Two Eritrean Hospitals

“…Hence, an Apgar score of nine and below was considered as bad outcome in our setting. In the study conducted by Harazim et al [6], outcomes of newborns born from mothers who underwent regional anesthesia for CS had significantly better Apgar scores compared to those who underwent general anesthesia. Our study did not compare spinal anesthesia with general anesthesia; this is a gap for future research in Eritrea.…”

“…Apgar scores recorded by an experienced neonatologist for every newborn are part of good clinical practice. In an international survey by Harazim et al [6], an experienced neonatologist was recording the Apgar score; thus a cut-off of seven and below was considered as poor outcome. In our case Apgar score below seven is considered as life-threatening.…”

“…Letting the mother awake, minimal depression of fetus, small drug dose, low failure rate, rapid onset, and simplicity of its technique make spinal anesthesia more popular than general anesthesia for CS [5]. Moreover better neonatal outcome was recorded for newborns from mothers who underwent regional anesthesia compared to general anesthesia for their CS [6]. Since 2001, more CS were being done under spinal anesthesia [7], but some countries reported higher rates of general anesthesia for CS [3].…”

A Single-center Retrospective Cohort Study on Cesarean Section under General Anesthesia

“…Some literatures showed no difference in neonatal outcomes between general and regional anesthesia for caesarean section when only out-of-risk newborns were analyzed. 18 But for the very preterm infants (27-32 weeks), multivariate analysis showed that neuraxial block was associated with an increased risk of neonatal mortality compared to GA, disregarding the gestational age, characteristics of pregnancy, delivery and neonates. 19 In conclusion, pregnancy with internal and sur-…”

Comparison of The Effects of General and Spinal on Apgar Scores of Babies Born Through Caesarean Section in RSUP Haji Adam Malik Medan from 2018 to 2019

“…Harazim in the Czech Republic and Slovakia published in 2015, which revealed no significant difference in the APGAR score at 10 minutes in either the general anesthesia group or spinal anesthesia. [13] 5 Conclusions…”